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Opinion

Will Obamacare deliver needed reforms? No

Free market can fix flaws in the health system

By R. Bruce Josten

Posted:
03/10/2013 12:01:00 AM MST

The Patient Protection and Affordable Care Act has failed to live up to its promises — or even its name. Instead, health-care costs continue to climb. Millions of Americans remain, and will continue to remain, uninsured or underinsured, while millions of others will lose the coverage they have.

Patients have inadequate information about the quality and value of many health-care services, limiting their ability to make well-informed choices. More Americans than ever are suffering from preventable chronic diseases, which significantly drive up costs. But one thing seems certain: The law isn't going anywhere. Therefore, additional efforts to advance the meaningful health-care solutions we need must be done in conjunction with implementation of the law. The business community is advocating several crucial changes.

First, we must find ways to bend the cost curve significantly. Our medical liability system breeds excessive litigation, encourages needless tests and procedures, and drives specialists from their practices. It must be reformed to bring down costs. We must expand competition, transparency and consumer choice. And we must reduce duplication and spending by deploying health information technology and attacking fraud and abuse in both public and private programs.

We also must address entitlement programs, which are on course to bankrupt the federal government and our states and threaten to leave future generations without a safety net.

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We can put these programs on sound footing by enacting reasonable and gradual changes. Higher premiums and co-pays should be phased in for those who can afford them. There must be incentives for greater choice and competition. We must do more to encourage and help low-income individuals obtain private insurance coverage and states should have greater flexibility in running their Medicaid programs.

We must prevent and manage chronic conditions and diseases such as obesity, high-blood pressure and diabetes, which are the leading drivers of health-care costs. Employers should promote workplace wellness and have the flexibility to incentivize healthy behaviors. Providers should be rewarded for improving health and wellness, not just treating illnesses. And it should be a national priority to promote wellness and personal health responsibility.

We must continue efforts to cover 45 million uninsured Americans and make sure that all citizens have access to affordable health services. There should be a level tax playing field for those who have insurance through their employers and those who buy it on their own. We should allow greater flexibility in both employer-sponsored and individually purchased plans so consumers can choose the plan that's right for them. We should encourage the expansion of community-based medical clinics to expand access to basic services.

We must improve quality through transparency and innovation. Consumers must have access to the performance records of doctors and hospitals, and they must share in the responsibility of making informed choices regarding treatments and services. Providers should be more clearly rewarded for quality care, health outcomes, and overall performance.

Finally, U.S. businesses, scientists and research institutions must continue to create new health care advances in products, treatments, and technologies — America can't afford to lose this competitive advantage. We can't reform American health care by simply passing another bill or enacting a new federal program. Genuine reform requires a society-wide effort.

R. Bruce Josten is executive vice president for government affairs at the U.S. Chamber of Commerce. These essays were distributed by McClatchy-Tribune News Service.

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